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目的 观察大剂量静脉滴注免疫球蛋白 (Iv Ig)在治疗系统性红斑狼疮 (SL E)继发血小板减少中的作用。方法 采用分组对照研究 ,对比不同治疗方案对 SL E继发血小板减少的疗效 :对照组口服 1mg/ (kg· d)强的松 +静脉滴注 0 .8～ 1.0 g/ 3～ 4周环磷酰胺 ,其余 3组除给予相同剂量的强的松和环磷酰胺外 ,分别给予连续 3d的 Iv Ig(2 0 g/ d)、甲基强的松龙 (MP)冲击及 Iv Ig+MP冲击。结果 Iv Ig、MP冲击、Iv Ig+MP冲击联用组血小板达高峰时间分别为 (6 .2± 4.4)、(7.3± 4.9)、(3.8± 2 .4) d,均较对照组 (31.0± 17.8) d明显缩短 (P<0 .0 1) ;Iv Ig+MP冲击联用组血小板达高峰时间亦显著低于单纯 MP冲击组 (P<0 .0 5 )。Iv Ig、MP冲击、Iv Ig+MP冲击 3组血小板计数峰值分别为 175 .1± 89.2、12 6 .8± 10 7.4及 12 8.4± 78.6 (× 10 9/ L) ,均显著高于对照组的 97.1± 6 1.3(×10 9/ L) (P<0 .0 5 )。结论 Iv Ig对 SL E继发血小板减少有显著疗效 ,且与 MP冲击联用有协同治疗作用。
Objective To observe the role of high-dose intravenous immunoglobulin (Iv Ig) in the treatment of secondary thrombocytopenia in systemic lupus erythematosus (SL E). Methods A group controlled study was conducted to compare the curative effects of different treatment regimens on secondary thrombocytopenia with SLE: The control group received oral prednisone 1 mg / (kg · d) + intravenous infusion of 0.8 ~ 1.0 g / 3 ~ 4 weeks of cyclophosphamide Amide, and the other three groups were given Iv Ig (20 g / d), methylprednisolone (MP) and Iv Ig + MP respectively in addition to the same dose of prednisone and cyclophosphamide . Results Compared with the control group, the peak time of platelet uptake in Iv Ig, MP and Iv Ig + MP groups was (6.2 ± 4.4), (7.3 ± 4.9) days and (3.8 ± 2.4 days) ± 17.8) d (P <0.01). The peak time of platelet uptake in Iv Ig + MP group was also significantly lower than that in MP group (P <0.05). The peak values of platelet counts in Iv Ig, MP and Iv Ig + MP groups were 175.1 ± 89.2,126.8 ± 10 7.4 and 12 8.4 ± 78.6 (× 10 9 / L), respectively, which were significantly higher than those in control group Of 97.1 ± 6 1.3 (× 10 9 / L) (P <0.05). Conclusions Iv Ig has a significant effect on secondary thrombocytopenia of SL E and has a synergistic therapeutic effect with MP shock.